Medical Ethics

Medical Ethics, a type of professional ethics concerning the activities and conduct of members of the medical profession. Professional ethics is the application of general concepts of morality to one or another branch of professional activity. The views on the essence and origin of ethical concepts differ among various authors. While for Kant ethics is the 'categorical imperative,' the concept of duty which hangs over people like some internal compulsive force, in the Marxist understanding ethics is the rules of behavior devoid of absolute categoricality, dictated by class interest and class self-consciousness and changing over centuries among different peoples and social groups, depending on economic, class, and political conditions. The specific ethical questions that a physician encounters relate to three aspects of his activity: 1) relationships with the patient, 2) relationships among physicians themselves, and 3) relationships with the social collective. At the same time, these three categories of relationships can come into conflict and give rise to difficult ethical problems. While a number of elementary rules of physician conduct (honesty and conscientiousness in performing one's duties, high demands on one's knowledge, skill, and work, impermissibility of delaying treatment for material gain or advertising ineffective means for selfish reasons) are completely obvious, matters are considerably more complex with questions such as using the patient for medical teaching purposes or for scientific experimentation. Here the interests of the patient and the G85 collective may contradict each other, and the physician faces the need to coordinate them with the least possible difficulty. In the area of relationships among physicians themselves, questions arise regarding the degree to which the interests of a fellow professional are observed and the boundaries of competition and other conflicts on the basis of professional medical activity. In this area, the accumulated experience of physicians' communication with each other in their professional sphere has developed a certain unwritten code of ethical rules, the violation of which is considered censurable in medical circles (for example, expressing before the patient an unfavorable opinion about the methods and treatment of the patient by the previous physician, an unjustified refusal to participate in a consultation at the patient's bedside, etc.). But there are cases when traditions also lead to improper behavior, such as deliberately concealing errors, and sometimes even unscrupulousness of one's colleague from a falsely understood sense of collegiality (which happens particularly frequently in forensic examinations), abuse of medical advertising, etc. Questions also arise as to how ethical it is to use state and public medical institutions for treating patients served under private fee-for-service practice, issuing certificates (sanitary supervision) and certificates of illness (labor expertise, determination for military service) to patients treated under private fee-for-service practice (the danger of a hidden form of bribery), etc. Here poorly understood rules of physician conduct may conflict with the interests of the patient and the collective. If for capitalist medicine, with its predominance of private practice and the inviolability of the curtain covering medical disciplines and activities for the uninitiated, conflicts in the area of the first two categories of relationships are typical—conflicts that are completely irreparable under the system of private capitalist medicine—then for social medicine there are different concepts of M.E. and different ethical conflicts. Thus, from the standpoint of social medicine and the interests of the collective, it should be considered unethical for German physicians to sabotage the work of insurance funds, to organize the non-admission of young workers to participate in the work of insurance funds, and the predominance of the principles of corporate interests of the 'medical estate' over the interests of the collective. The principles of Soviet healthcare fundamentally improve the trends of ethical foundations in medicine. The state organization of healthcare, accessibility and free medicine, its construction on social foundations with the elimination or restriction of private practice, sanitary education gradually removing the veil of mystery from all actions of representatives of the medical estate—all this educates the physician as a conscious member of the collective, establishes a cleaner atmosphere in the relationships between the physician and the patient and among physicians themselves, and radically destroys the mercenary spirit that continues to dominate in this field in a number of bourgeois countries. The principles of Soviet medicine remove the main stumbling block in the area of M.E.—the question of payment for medical care and advice. On the other hand, a number of other requirements arise for the physician, the violation of which should be considered under social medicine an unethical act. This includes, for example, the refusal of unemployed physicians in cities to go to work in the countryside. Besides such individual private questions, the ethics of the physician is entirely covered by the general requirements that the collective makes of its member; M.E. cannot be considered as something isolated from the general foundations of morality and ethics in a given social group.